毛冬青(IP)作为鼻咽癌放射治疗增敏剂的临床观察(Ⅰ)

A CLINICAL TRIAL WITH ILEX PUBESCENS AS A RADIOS-ENSITIZER TO NASOPHARYNGEAL CARCINOMA ( Ⅰ )

本研究首次采用毛冬青(IP)对102例鼻咽癌患者进行临床对照试验,其目的是观察IP对鼻咽癌是否有放射增敏作用。结果表明,IP+放射组在治疗后2～3个月内鼻咽肿瘤肉眼和CT的全消率分别为100％和57.1％,均明显高于放射组(71.2％和29.5％);颈淋巴结消失时的平均放射剂量也明显低于放射组,增敏比达1.54;临床Ⅲ、Ⅳ期的全消率也以IP+放射组为高。说明IP能提高放射对鼻咽癌原发肿瘤及颈淋巴结的近期灭癌效应(尤其对中晚期者效果更好)。本文还显示使用IP联合放射是安全的,不但不会增加皮肤和胃肠道的放射反应,而且对口咽粘膜反应还有一定减轻作用。对IP的放射增敏机制也进行了探讨。

Ilex pubescens (IP) is a Chinese herb. A clinical control trial with IP combined with radiation for nasopharyngeal carcinoma (NPC) was carried out. The purpose was to evaluate the radiosensitization of IP. From October 1988 till August 1989, 102 patients with NPC were divided into the control group (radiation alone) and combined treatment group (IP+radiation) at random. About 2 hours after IP 80mg iv drip, the radiation was carried out by 60 Co or 9 Mev linac. The remission of nasopharyngeal tumor in the combined group revealed a remarkably better result than in the control group 2-3 months after treatment, the remission rates by clinical and CT examination was 100% (50/50) and 57.1% (24/42) for the combined treatment group respectively, but 71.2% (37/52) and 29.5% (13/44) only for the control group correspondingly (P<0.01) . The difference was especially more obvious between the T3-4 cases in the two groups. The average remission dose of cervical nodes in the combined treatment group was also lower than the control group, enhacement ratio was 1.54. Furthermore, the remission rates of stage Ⅲ and Ⅳ patients with NPC in the combined group , 100%(26/26) and 81.8% (18/22) respectively, were higher than the control group, 59.3% (16/27) and 50.0% (10/20) , respectively (P< 0.05) . No difference was noted on acute radio-reaction of the skin and gastrointestinal tract between the two groups. However, the acute reaction of mucosa of the mouth and pharynx in the combined treatment group was milder than the control group. From the results of this study we concluded that IP had some effect as a 'radiosensitizer' to radiotherapy for NPC( especially stage Ⅲ- Ⅳ), but further study is needed to comfirm this .